Spring Tide Counseling, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SPRING TIDE COUNSELING, LLC

Practice address

600 University Ave
Fairbanks, AK 99709-3660

Phone

(907) 415-4727

NPI assigned

Aug 15, 2024

Last updated

Aug 15, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sarah Jensen, LCSWNPI 1386331221

Title

Owner/President

Phone

(907) 415-4727

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sarah Jensen, LCSW

  • Clinical Social Worker
  • Fairbanks, AK
  • NPI 1386331221
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1225860612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81251",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997081251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 UNIVERSITY AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093660",
            "telephone_number": "907-415-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING TIDE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "907-415-4727",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Community/Behavioral Health Agency in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.